# Logic Model / Theory of Change Template

Use this worksheet when a team needs to connect a medtech product idea to adoption, evidence, and outcomes. Keep it short enough to review with clinical, operations, privacy, security, business, and technical stakeholders.

## Product or Pilot

- Product / pilot name:
- Target setting:
- Target users:
- Patient or operational problem:
- Intended use / claim boundary:

## Theory of Change

If we provide:

Then users will:

Because:

Leading to:

Measured by:

## Logic Model

| Inputs | Activities | Outputs | Short-Term Outcomes | Long-Term Outcomes |
| --- | --- | --- | --- | --- |
| Clinical champions, product team, privacy advisor, pilot sites, patient app, dashboard, cloud hosting budget | Map workflow, complete PIA inputs, build pilot workflow, train users, monitor usage and support tickets | Pilot protocol, trained users, active app accounts, dashboard reviews, support logs, risk register updates | Faster review of target cases, fewer incomplete referrals, clearer escalation path, measurable support load | Repeatable deployment model, stronger evidence package, procurement-ready business case |

## Assumptions

- Users have enough workflow capacity to adopt the change.
- Data access and privacy review are feasible in the target setting.
- The product can be supported safely during the pilot.
- The operating cost fits the business model.

## Risks to Test

- Clinical workflow does not change enough to justify adoption.
- Integration or data access takes longer than planned.
- Support burden is higher than expected.
- Evidence collected during the pilot is not persuasive for the next buyer.

## Example: Alberta Referral Triage Pilot

If a primary care clinic uses structured digital intake and referral completeness checks, then staff can submit more complete referrals because missing data is caught before specialist review. This should reduce back-and-forth communication, shorten time to triage, and produce evidence for a broader integration decision.